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Individual
WILLIAM C COULTER
Active
Individual
WILLIAM C COULTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA436
KY
363AM0700X
Medical Physician Assistant
PA436
KY
363AS0400X
Surgical Physician Assistant
PA436
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000655589
ANTHEM BCBS
KY
01
—
000000667983
COOP HEALTH ANTHEM #
KY
05
—
95001442
—
KY
Enumeration date
05/04/2006
Last updated
08/17/2020
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